Radiomics predicts risk of cachexia in advanced NSCLC patients treated with immune checkpoint inhibitors
Menée à partir de données cliniques et tomographiques portant sur 210 patients atteints d'un cancer du poumon non à petites cellules de stade avancé traité par inhibiteurs de point de contrôle immunitaire, cette étude met en évidence la performance d'une signature radiomique pour prédire le risque de cachexie
Background : Approximately 50% of cancer patients eventually develop a syndrome of prolonged weight loss (cachexia), which may contribute to primary resistance to immune checkpoint inhibitors (ICI). This study utilised radiomics analysis of 18F-FDG-PET/CT images to predict risk of cachexia that can be subsequently associated with clinical outcomes among advanced non-small cell lung cancer (NSCLC) patients treated with ICI.
Methods : Baseline (pre-therapy) PET/CT images and clinical data were retrospectively curated from 210 ICI-treated NSCLC patients from two institutions. A radiomics signature was developed to predict the cachexia with PET/CT images, which was further used to predict durable clinical benefit (DCB), progression-free survival (PFS) and overall survival (OS) following ICI.
Results : The radiomics signature predicted risk of cachexia with areas under receiver operating characteristics curves (AUCs)
≥
0.74 in the training, test, and external test cohorts. Further, the radiomics signature could identify patients with DCB from ICI with AUCs
≥
0.66 in these three cohorts. PFS and OS were significantly shorter among patients with higher radiomics-based cachexia probability in all three cohorts, especially among those potentially immunotherapy sensitive patients with PD-L1-positive status (p < 0.05).
Conclusions : PET/CT radiomics analysis has the potential to predict the probability of developing cachexia before the start of ICI, triggering aggressive monitoring to improve potential to achieve more clinical benefit.
British Journal of Cancer , résumé, 2021